Obstructive sleep apnea and longitudinal Alzheimer's disease biomarker changes

STUDY OBJECTIVES

To determine the effect of self-reported clinical diagnosis of obstructive sleep apnea (OSA) on longitudinal changes in brain amyloid PET and CSF biomarkers (Aβ42, T-tau, and P-tau) in cognitively normal (NL), mild cognitive impairment (MCI), and Alzheimer's disease (AD) elderly.

METHODS

Longitudinal study with mean follow-up time of 2.52 ± 0.51 years. Data were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Participants included 516 NL, 798 MCI, and 325 AD elderly. Main outcomes were annual rate of change in brain amyloid burden (i.e. longitudinal increases in florbetapir PET uptake or decreases in CSF Aβ42 levels); and tau protein aggregation (i.e. longitudinal increases in CSF total tau [T-tau] and phosphorylated tau [P-tau]). Adjusted multilevel mixed effects linear regression models with randomly varying intercepts and slopes was used to test whether the rate of biomarker change differed between participants with and without OSA.

RESULTS

In NL and MCI groups, OSA+ subjects experienced faster annual increase in florbetapir uptake (B = .06, 95% CI = .02, .11 and B = .08, 95% CI = .05, .12, respectively) and decrease in CSF Aβ42 levels (B = -2.71, 95% CI = -3.11, -2.35 and B = -2.62, 95% CI = -3.23, -2.03, respectively); as well as increases in CSF T-tau (B = 3.68, 95% CI = 3.31, 4.07 and B = 2.21, 95% CI = 1.58, 2.86, respectively) and P-tau (B = 1.221, 95% CI = 1.02, 1.42 and B = 1.74, 95% CI = 1.22, 2.27, respectively); compared with OSA- participants. No significant variations in the biomarker changes over time were seen in the AD group.

CONCLUSIONS

In both NL and MCI, elderly, clinical interventions aimed to treat OSA are needed to test if OSA treatment may affect the progression of cognitive impairment due to AD.

Establishing funding rates for colonoscopy and gastroscopy procedures in Ontario

Introduction

This paper describes the funding rates established in Ontario to reflect best practices in hospital-based care delivery for these endoscopic procedures: colonoscopy, colonoscopy biopsy, gastroscopy, gastroscopy biopsy, and colonoscopy combined with gastroscopy.

Methods

The funding rates are based on direct costs and were established using a micro-costing approach after receipt of inputs from 3 working groups and a review of the administrative data and literature, where applicable. The first group advised on nursing activities, time, and staffing ratios along the patient pathway for each of the procedures. The second group provided recommendations about the duration for each procedure, and the third group provided information about supplies and equipment, their use, and costs.

Results

The resulting funding rates are $161.18 for colonoscopy and $151.08 for gastroscopy (without accompanying interventions), $16.06 for colonoscopy biopsy and $8.22 for gastroscopy biopsy (added to the respective procedures), and $207.26 for combined colonoscopy and gastroscopy. Detailed costs for each component embedded in the rates are also provided.

Conclusions

The rates came into effect in April 2018. The process and outcomes described here allowed for a transparent pricing mechanism in which funding follows the patient, clinical expert consensus is the basis for practice, and providers and payers both understand the components.

Psychosocial, psychopharmacological and demographic predictors of changes in psychological distress over a course of computerised cognitive behavioural therapy (cCBT)

Social group identification, socioeconomic deprivation, and a number of other clinical and demographic factors have been found to predict severity of psychological distress prior to treatment in those referred to receive computerised cognitive behavioural therapy (cCBT) as an intervention for mild to moderate depression. The aim of the current study is to investigate whether the same key factors are able to predict magnitude of change in psychological distress across treatment in a sample receiving cCBT. Participants (N = 1158) consisted of individuals completing the 'Beating the Blues' (BtB) programme. Participants completed three versions of the group identifications scale (GIS), one for each of three groups: family, community, and a social group of choice. Changes in psychological distress showed statistically significant improvements between pre- and post-treatment assessment in all outcome measure subscales. Significantly greater changes (reductions) in psychological distress were found in those who had more severe pre-treatment psychological distress, those who lived in a lesser state of socioeconomic deprivation, those who identified with more social groups, and those taking antidepressant medication (ADM) concurrently. These findings provide valuable information on the likely course of treatment in those receiving cCBT, and highlight both the potential of social group identification as a 'social cure' for poor psychological health and the inequalities of the socioeconomic health gradient.

Benzyl alcohol oxidation with Pd-Zn/TiO2: computational and experimental studies

Pd-Zn/TiO2 catalysts containing 1 wt% total metal loading, but with different Pd to Zn ratios, were prepared using a modified impregnation method and tested in the solvent-free aerobic oxidation of benzyl alcohol. The catalyst with the higher Pd content exhibited an enhanced activity for benzyl alcohol oxidation. However, the selectivity to benzaldehyde was significantly improved with increasing presence of Zn. The effect of reduction temperature on catalyst activity was investigated for the catalyst having a Pd to Zn metal molar ratio of 9:1. It was found that lower reduction temperature leads to the formation of PdZn nanoparticles with a wide particle size distribution. In contrast, smaller PdZn particles were formed upon catalyst reduction at higher temperatures. Computational studies were performed to compare the adsorption energies of benzyl alcohol and the reaction products (benzaldehyde and toluene) on PdZn surfaces to understand the oxidation mechanism and further explain the correlation between the catalyst composition and its activity.

Human impact erodes chimpanzee behavioral diversity

Chimpanzees possess a large number of behavioral and cultural traits among nonhuman species. The "disturbance hypothesis" predicts that human impact depletes resources and disrupts social learning processes necessary for behavioral and cultural transmission. We used a dataset of 144 chimpanzee communities, with information on 31 behaviors, to show that chimpanzees inhabiting areas with high human impact have a mean probability of occurrence reduced by 88%, across all behaviors, compared to low-impact areas. This behavioral diversity loss was evident irrespective of the grouping or categorization of behaviors. Therefore, human impact may not only be associated with the loss of populations and genetic diversity, but also affects how animals behave. Our results support the view that "culturally significant units" should be integrated into wildlife conservation.

In situ synthesis of CuO nanoparticles over functionalized mesoporous silica and their application in catalytic syntheses of symmetrical diselenides

A versatile and novel mesoporous silica supported CuO nanoparticle catalyst (nCuO-FMS) and its application in the syntheses of symmetrical diselenides.

Adsorption of phosphorus with calcium alginate beads containing drinking water treatment residual

Aluminum-based drinking water treatment residuals (DWTR) were encapsulated by alginate to develop a pelletized media (DWTR-CA beads) for phosphorus (P) adsorption. The beads were successfully manufactured to uniform size and shape requirements. The effects of DWTR powder concentration and particle size, and bead mean size on P adsorption, were investigated. The DWTR was found to be an important component in the beads for P adsorption, while the calcium alginate shell contributed little for P adsorption. The maximum P adsorption capacity of the DWTR-CA bead was 19.42 mg P/g wet beads, corresponding to a bead diameter of 3.1 ± 0.2 mm and DWTR concentration of 2% (1% weight/volume (W/V)), mg/mL). The adsorption data fit well with the intra-particle diffusion model and the pseudo-second-order kinetic model, while both the Langmuir and Freundlich adsorption isotherms described the adsorption process well. Furthermore, the study on the effect of pH on P adsorption showed that acidic conditions resulted in a better P adsorption and the DWTR-CA beads have the function of pH neutralization. The findings of this study show that the DWTR-CA beads are a promising adsorbent/substrate for P removal.

A Phase II Trial of Bortezomib and Vorinostat in Mantle Cell Lymphoma and Diffuse Large B-cell Lymphoma

BACKGROUND

The proteasome inhibitor bortezomib has demonstrated marked preclinical activity when combined with the histone deacetylase inhibitor vorinostat in leukemia, multiple myeloma, and mantle cell lymphoma (MCL) cells. The present study evaluated the efficacy and safety of the combination in patients with relapsed or refractory MCL and diffuse large B-cell lymphoma (DLBCL).

PATIENTS AND METHODS

The present multicenter, nonrandomized phase II trial used a Simon 2-stage design with 3 cohorts: cohort A, MCL with no previous bortezomib (including untreated MCL); cohort B, MCL with previous bortezomib; and cohort C, relapsed or refractory DLBCL with no previous bortezomib. Vorinostat (400 mg) was administered orally on days 1 to 5 and 8 to 12 before bortezomib (1.3 mg/m2), which was administered intravenously on days 1, 4, 8, and 11 of each 21-day cycle.

RESULTS

For the 65 treated patients (22 in cohort A, 4 in cohort B, and 39 in cohort C), the overall response rate was 31.8%, 0%, and 7.7%, respectively. The median progression-free survival was 7.6 months for cohort A and 1.8 months for cohort C. In cohort A, 7 patients had a partial response (PRs), 5 had stable disease (SD), 7 had progressive disease (PD), 1 was not assessed, and 2 were not evaluable. In cohort B, 2 had SD and 2 had PD. In cohort C, 3 had a PR, 8 had SD, 23 had PD, and 5 were not assessed. Baseline NF-κB activation, measured as nuclear RelA by immunohistochemistry, did not correlate with clinical response.

CONCLUSION

The combination of bortezomib and vorinostat is safe and has modest activity in MCL and limited activity in DLBCL.

Spectroscopy of Surface-State p-Doped CdSe/CdS Quantum Dots

Transient absorption (TA) and time-resolved photoluminescence (PL) spectroscopies have been used to provide direct spectroscopic evidence for the recently reported phenomenon of thermal "surface charging" in II-VI quantum dots (QDs). In these studies, zincblende CdSe cores are synthesized by standard methods, and a thin CdS shell deposited by the decomposition of Cd(DDTC)₂, resulting in core/shell QDs with chalcogenide-rich surfaces. Following ligand exchange with oleylamine, these QDs have empty low-lying surface states that can be thermally populated from the valence band. At room temperature, the surface charging equilibrium results in some fraction of the particles having a hole in the valence band, i.e., the surface acceptor states make the particle p-type. Photoexcitation of the surface charged state results in what is essentially a positive trion, which can undergo a fast Auger recombination. Both PL and TA (bleach recovery) kinetics of the CdSe/CdS QDs show a 70 ps decay component, which is assigned to Auger recombination. The empty nonbonding surface orbitals are passivated by ligation with a trialkylphosphine, and the fast decay component is absent when tributylphosphine is present. The comparison of the TA and PL kinetics shows that the relative amplitude of the 70 ps component is a factor of about 1.5 greater in the TA than in the PL. They also show that the fast component in the PL spectrum is shifted about 6 nm to the blue of the exciton luminescence. The above observations can be understood in terms of the trion versus exciton spectroscopy and strongly support the assignment of the 70 ps transient to the decay of a trion formed from the surface charged state.

Global development of various emerged substrates utilized in constructed wetlands

Substrate selection is one of the key technical issues for constructed wetlands (CWs), which works for wastewater treatment based mainly on the biofilm principle. In recent years, many alternative substrates have been studied and applied in CWs, and a review is conducive to providing updated information on CW R&D. Based on the intensive research work especially over the last 10 years on the development of emerged substrates (except for the three conventional substrates of soil, sand, and gravel) in CWs, this review was made. The substrates are categorized depending on their main roles in pollutant removal as ion-exchange substrates, P-sorption substrates, and electron donor substrates. Among these, reuse of various waste products as substrates was suggested due to their competitive pollutant removal efficiency and minimized waste disposal. Regarding substrate development, future research on avoiding substrate clogging to extend their lifetime in CWs is needed.

The consequence of matrix dysfunction on lung immunity and the microbiome in COPD

The pulmonary extracellular matrix (ECM) is a complex network of proteins which primarily defines tissue architecture and regulates various biochemical and biophysical processes. It is a dynamic system comprising two main structures (the interstitial matrix and the basement membrane) which undergo continuous, yet highly regulated, remodelling. This remodelling process is essential for tissue homeostasis and uncontrolled regulation can lead to pathological states including chronic obstructive pulmonary disease (COPD). Altered expression of ECM proteins, as observed in COPD, can contribute to the degradation of alveolar walls and thickening of the small airways which can cause limitations in airflow. Modifications in ECM composition can also impact immune cell migration and retention in the lung with migrating cells becoming entrapped in the diseased airspaces. Furthermore, ECM changes affect the lung microbiome, aggravating and advancing disease progression. A dysbiosis in bacterial diversity can lead to infection, inducing epithelial injury and pro-inflammatory reactions. Here we review the changes noted in the different ECM components in COPD and discuss how an imbalance in microbial commensalism can impact disease development.